CHANGE OF ADDRESS FORM - University of Nevada, Reno

Office of International Students and Scholars
120 Fitzgerald Student Services Building/0074
Reno, Nevada 89557
Tel.: (775) 784-6874 Fax: (775) 327-5845
[email protected]
CHANGE OF ADDRESS FORM
Address updates must be submitted to OISS within 10 days. You may fax, scan and email, or bring the completed
form to OISS. STUDENTS: if you update your mailing address and phone number in MyNEVADA you do
not need to submit this form.
Last Name: ______________________________________
First Name: ___________________________
Date of Birth (Month / Day / Year): _________________
Visa Type:  F-1  H-1  J-1  TN
SEVIS ID Number: N _________________________
NSHE ID: ________________________
Current Phone: _______________________ _______________________ _______________________
Home
Work
Cell
Email: _______________________________________________
NEW ADDRESS
Mailing Address: Where do you want your mail sent?
Address Line 1: _____________________________________________________________________________
Address Line 2/Apartment or Room #: ___________________________________________________________
City: ________________________________ State: ______________ Zip Code: ________________________
Physical (Local) Address: If different from mailing
Address Line 1: _____________________________________________________________________________
Address Line 2/Apartment or Room #: ___________________________________________________________
City: ________________________________ State: ______________ Zip Code: ________________________
Permanent Address: In country of permanent residence
Address Line 1: _____________________________________________________________________________
Address Line 2/Apartment or Room #: ___________________________________________________________
City: _____________________________ State/Province: ______________ Postal Code: _________________
Country: __________________________________________________
A copy of the signature on this form is valid as the original.
Signature: ______________________________________ Date (Month / Day / Year): _______________
OISS USE ONLY
fsaATLAS: _________________________
SEVIS: ____________________________
Listserv: ___________________________
FORMS  CHANGE OF ADDRESS FORM  April 14